Loading...
HomeMy WebLinkAboutMarcia Nelson - Form 700i '_P STATEMENT OF ECONOMIC INTERESTS COVER PAGE Please type or print in ink. A Public Document Date Received 011lcial Use Only NAME (LAST) (FIRST) (MIDDLE) DAYTIME TELEPHONE NUMBER �JEL-snk), �x4PGG-16� k joo) O.1s'05 /F MAILING ADDRESS STREET CITY STATE ZIP CODE OPTIONAL: FAX / E -MAIL ADDRESS (May use business address) . SAO LW 5 U15L)0 i r/A 1. Office, Agency, or Court {Name of Office, Agency, orr Court: L( y C obi C'IL_Mfor:fir r Divisidlk, Board, District, if applicable: Your Position: If filing for multiple positions, list additional agency(ies)/ position(s): (Attach a separate sheet if necessary.) Agency: Position: 2. Jurisdiction of Office (Check at least one box) ❑ State ❑ County of ® city of 5AW L-JA,c ( CQ a S PO ❑ Multi- County ❑ Other -- _---- - -��__ 13. Type of Statement (Check at least one box) ❑ Assuming Office /Initial Date: Annual: The period covered is January 1, 2007, through December 31, 2007. -or- 0 The period covered is through December 31, 2007. ❑ Leaving Office Date Left: J— if (Check one) O The period covered is January 1, 2007, through the date of leaving office. .or- 0 The period covered is — I through the date of leaving office. [ Candidate 4. Schedule Summary "► Total number of pages 2 including this cover page: "► Check applicable schedules or "No reportable interests." I have disclosed interests on one or more of the attached schedules: Schedule A -1 ❑ Yes - schedule attached Investments (Less than 10% Ownership) Schedule A -2 ❑ Yes - schedule attached Investments (10% or greater Ownership) Schedule B ❑ Yes - schedule attached Real Property Schedule C Yes - schedule attached Income, Loans, & Business Positions (Income Other than Gilts and Travel Payments) Schedule D ❑ Yes - schedule attached Income - Gifts Schedule E ❑ Yes - schedule attached income — Travel Payments .or- F] No reportable interests on any schedule 5. Verification I have used all reasonable diligence in preparing this statement. I have reviewed this statement and to the best of my knowledge the information contained herein and in any attached schedules is true and complete. I certify under penalty of perjury under the laws of the State of California that the foregoing is true and correct. Date Signed WZ7 C) montth,dday, year)) (T (r ae originally signed statement with your filing ofr+clal.) FPPC Form 700 (2007/2008) FPPC Toll -Free Helpline: 866 /ASK -FPPC WHAT SCHEDULE DO I USE TO REPORT? Businesspositions ........................................................... ............................... .......................Schedule A -2 or Schedule C Commission income ........... ............................... ......................Schedule A -2 or Schedule C (see Ref. Pamphlet, page 7) Gifts received by family members ..... ............................... .....................Disclosure may not be required, see.Schedule D Gifts received from family members ................................... ............................... Disclosure not required, see Schedule D Incometo my business .................................................................................................. ............................... Schedule A -2 Individual Retirement Account ........................ .......................Schedule A -1 or Schedule B (see Ref. Pamphlet, page 14) Investments......................................................................................... ............................... Schedule A -1 or Schedule A -2 Loans made to others ....................... ............................... Disclosure not required, but report repayments on Schedule C Loans received ................................................................ ..................._........... Schedule B for real property or Schedule C Loansto my business .................................................................................................... ............................... ScheduleA -2 Owning a business or partnership IfI own less than 10% .............................................................................................. ............................... Schedule A -1 IfI own 10% or more ................................................................................................ ............................... Schedule A -2 Real estate holdings ............................. ............................... Schedule B (Schedule A -2 if held by a business entity /trust) Rentalincome ..................................................................... ............................... .......................Schedule B or Schedule C Rental property ..................................... ............................... Schedule B (Schedule A -2 if held by a business entity /trust) Saleof my home /automobile/ boat .......... ..................................................................... ..................................... Schedule C Soleproprietorship ....................... ....................... ................................................... ...................................... Schedule A -2 Spouse's or registered domestic partner's income........... .... ........................... ......................Schedule A -2 or Schedule C Stock holdings IfI own less than 10% of a company's stock ...................................................,........ ............................... Schedule A -1 If I own 10% or more of a company's stock .............................................................. ............................... Schedule A -2 Ticketsand passes ................................................................ ............................... .... ............................... Schedule D Travel reimbursements or payments .................................................,.............................. ............................... Schedule E Trusts ........................................................................... ............................... Schedule A -2 (see Ref. Pamphlet, page 14) FPPC Form 700 (2007/2008) FPPC Toll -Free Helpline: 866 /ASK -FPPC www.fppc.ca.gov Instructions - 2 SCHEDULE C Income, Loans, & Business Positions (Other than Gifts and Travel Payments) NAME OF SOURCE OF INCOME l„1e, ADDR SS ('n � .orb ApPure BUSINESS ACTIVITY, IF ANY, OF SOURCE ATL A fA YOUR 9SINESS POSITION I R— U aEs GROSS INCOME RECEIVED ❑ $500 - $1,000 ❑ $1,001 - $10,000 N] $10,001 - $100,000 ❑ OVER $100,000 CONSIDERATION FOR WHICH INCOME WAS RECEIVED © Salary ❑ Spouse's or registered domestic partner's income ❑ Loan repayment ❑ Sale of (Property, car, boat, etc) ❑ Commission or ❑ Rental Income, list each source of $10,000 or more ❑ Other (Describe) CALIFORNIA FORM 700 FAIR POLITICAL PRACTICES COMMISSION Name MA ! i NAME OF SOURCE OF INCOME ADDRESS BUSINESS ACTIVITY, IF ANY, OF SOURCE YOUR BUSINESS POSITION GROSS INCOME RECEIVED ❑ $500 - $1,000 ❑ $1,001 - $10,000 ❑ $10,001 - $100,000 ❑ OVER $100,000 CONSIDERATION FOR WHICH INCOME WAS RECEIVED ❑ Salary ❑ Spouse's or registered domestic partner's income ❑ Loan repayment ❑ Sale of (Property, car, boat, etc.) ❑ Commission or ❑ Rental Income, list each source of $10,000 or more ❑ Other (Describe) 1> 2. LOAN RECEMED * You are not required to report loans from commercial lending institutions, or any indebtedness created as part of a retail installment or credit card transaction, made in the lender's regular course of business on terms available to members of the public without regard to your official status. Personal loans and loans received not in a lender's regular course of business must be disclosed as follows: NAME OF LENDER` ADDRESS BUSINESS ACTIVITY, IF ANY, OF LENDER HIGHEST BALANCE DURING REPORTING PERIOD ❑ $500 - $1,000 ❑ $1,001 - $10,000 ❑ $10,001 - $100,000 ❑ OVER $100,000 Comments: INTEREST RATE TERM (MonthsNears) ❑ None SECURITY FOR LOAN ❑ None ❑ Personal residence ❑ Real Property ❑ Guarantor ❑ Other (Describe) FPPC Form 700 (2007/2008) Sch. C FPPC Toll -Free Helpline: 866 1ASK -FPPC INSTRUCTIONS — SCHEDULE C INCOME, LOANS, & BUSINESS POSITIONS (Income Other Than Gifts and Travel Payments) Report the source and amount of gross income of $500 or more you received during the reporting period. Gross income is the total amount of income before deducting expenses, losses, or taxes and includes loans other than loans from a commercial lending institution. (See Ref. Pamphlet, page 10.) Also report your job title with each reportable business entity, even if you received no income during the reporting period. You must also report the source of income to your spouse or registered domestic partner if your community property share is $500 or more during the reporting period. A source of income must be reported only if the source is located in, doing business in, planning to do business in, or has done business during the previous two years in your agency's jurisdiction. (See Ref. Pamphlet, page 12, for more information about doing business in the jurisdiction.) Reportable sources of income may be further limited by your agency's conflict -of- interest code. Commonly reportable income and loans include: • Salary/wages, per diem, reimbursement for expenses including travel payments provided by your employer • Community property interest (50 %) in your spouse's or registered domestic partner's income - report the employer's name and all other required information • Income from investment interests, such as partnerships, reported on Schedule A -1 • Commission income not required to be reported on Schedule A -2 (See Ref. Pamphlet, page 7.) • Gross income from any sale, including the sale of a house or car (report your pro rata share of the total sale price) • Rental income not required to be reported on Schedule B • Prizes or awards not disclosed as gifts • Payments received on loans you made to others, including loan repayments from a campaign committee • An honorarium received prior to becoming a public official (See Ref. Pamphlet, page 9, concerning your ability to receive future honoraria.) • Incentive compensation (See Ref. Pamphlet, page 11.) REMINDERS • Code filers — Your disclosure categories may not require disclosure of all sources of income. • If you or your spouse or registered domestic partner are self - employed, report the business entity on Schedule A -2. • Do not disclose on Schedule C income, loans or business positions already reported on Schedules A -2 or B. You are not required to report: Salary, reimbursement for expenses or per diem, social security, disability, or other similar benefit payments received by you or your spouse or registered domestic partner from a federal, state, or local government agency See Ref. Pamphlet, page 11, for more exceptions to income reporting. TO COMPLETE SCHEDULE C: 1. Income Received /Business Position Disclosure • Disclose the name and address of each source of income or each business entity with which you held a business position. • Provide a general description of the business activity if the source is a business entity. • Disclose the job title or business position, if any, that you held with the business entity, even if you did not receive income during the reporting period. • Check the box indicating the amount of gross income received. • Identify the consideration for which the income was received. • For income from commission sales, check the box indicating the gross income received and list the name of each source of commission income of $10,000 or more. (See Ref. Pamphlet, page 7.) • For income from rental property that is not required to be listed on Schedule B, enter "Rental Income" under "Name of Source," check the box indicating the gross income received, and, if you had a 10% or greater interest in the rental property, list the name of each tenant if your pro rata share of the gross income from that tenant was $10,000 or more during the reporting period. 2. Loan Received • Disclose the name and address of each lender. • Provide a general description of the business activity if the lender is a business entity. • Check the box indicating the highest balance of the loan during the reporting period. • Disclose the interest rate and the term of the loan. -- The term of the loan is the total number of months or years given for repayment of the loan at the time the loan was entered into. -- For variable interest rate loans, disclose the conditions of the loan (for example, Prime + 2) or the average interest rate paid during the reporting period. Identify the security, if any, for the loan. FPPC Form 700 (2007/2008) FPPC Toll -Free Helpline: 866 /ASK -FPPC www.fppc.ca.gov Instructions - 8